| NPI | 1457730194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH EDMONDS Owner/Operator 720-257-1752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 11693) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2022-04-22 |